Hydration Haven

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

HYDRATION HAVEN

Practice address

5600 NW 57TH Way
Tamarac, FL 33319-2420

Phone

(786) 290-5415

NPI assigned

Feb 5, 2021

Last updated

Feb 5, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Marsha Jackson, APRNNPI 1609464130

Title

Owner

Phone

(786) 290-5415

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Marsha Jackson, APRN

  • Adult Health Nurse Practitioner
  • Tamarac, FL
  • NPI 1609464130

  Single Specialty

  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1612483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612483200000",
    "number": "1376135889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5600 NW 57TH WAY",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333192420",
            "telephone_number": "786-290-5415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 NW 57TH WAY",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333192420",
            "telephone_number": "786-290-5415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HYDRATION HAVEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-05",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "MARSHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-290-5415",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Huertas Batista
• Chemelle S Huggins
• Syed Mubashir Husain, MD
• Tracy-Ann Damiela Hutchinson
• Ing Sei Hwang, MD
• Hylan Home Care Agency LLC
• Chalae Frances Hylton
• Hyperbaricsrx LLC
• I. Marvin Ernst, DDS, PA
• Emad Ibrahim

• Primary Care Nurse Practitioner in Tamarac, FL
• Providers in Tamarac, FL by specialty
• Primary Care Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.